Multicomponent physical activity program to prevent body changes and metabolic disturbances associated with antiretroviral therapy and improve quality of life of people living with HIV: a pragmatic trial

Author(s)

Elisabete Cristina Morandi dos Santos ^[1] ; Alex Antonio Florindo ^[2] ; Ardiles Vitor Santos ^[3] ; Camila de Melo Picone ^[4] ; Túlio Gamio Dias ^[5] ; Aluisio Cotrim Segurado ^[6]

Affiliation

^[1] Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo. Divisao/Departamento de Molestias Infecciosas e Parasitarias - Brasil

^[2] Universidade de Sao Paulo. Escola de Ciencias, Artes e Humanidades - Brasil

^[3] Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo. Divisao/Departamento de Molestias Infecciosas e Parasitarias - Brasil

^[4] Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo. Divisao/Departamento de Molestias Infecciosas e Parasitarias - Brasil

^[5] Prefeitura Municipal de Joinville - Brasil

^[6] Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo. Divisao/Departamento de Molestias Infecciosas e Parasitarias - Brasil

• Document type: Journal article
• Source: Clinics; v. 76, 2021-03-24.

Abstract

OBJECTIVES: Comprehensive care for people living with human immunodeficiency virus (HIV) (PLH) includes the promotion of healthier habits, including physical activity (PA). This study aimed to describe a multicomponent pragmatic trial protocol to assess the effect of PA in preventing body changes and metabolic disturbances, improving the quality of life of PLH starting antiretroviral therapy (ART) and present cohort characteristics. METHODS: PLH undergoing ART for ≤4 months were recruited for a randomized trial. The intervention comprised three cardiorespiratory and/or strength training sessions per week at the clinic or in public spaces for 6 months under on-site or remote supervision, and educational sessions. Participants’ PA levels, cardiorespiratory fitness, anthropometric measures, strength, flexibility, quality of life, and laboratory monitoring (blood glucose and lipids, CD4 counts) at baseline and post-intervention will be compared. The pragmatic design aims to enable the assessment of intervention effectiveness in real-life conditions. RESULTS: At baseline, our cohort of 38 recently diagnosed patients (mean time since HIV diagnosis and duration of ART were 3 and 2.58 months, respectively) were predominantly male, young, with high schooling and good immune status (median CD4 count=498 cells/mm3). Twenty-two (57.9%) patients reported a PA below the World Health Organization recommendations. We found baseline normal anthropometric measures and metabolic parameters: below-average trunk flexion and elbow extension strength, poor handgrip strength and flexibility, and high quality of life scores in all except the physical domain. CONCLUSIONS: Understanding how effective PA is in preventing body changes and metabolic disturbances, and in improving the quality of PLH starting ART may help establish guidelines to better incorporate PA in HIV care. (AU)

• FAPESP's process: 13/20249-3 - Evaluation of the effect of physical activity in the primary prevention of body changes and blood carbohydrate and lipid biochemistry, and on inflammatory markers, vascular function and QOL of PLWHA under highly active antiretroviral therapy
• Grantee: Aluisio Augusto Cotrim Segurado
• Support Opportunities: Regular Research Grants